| Wild Goose Marriage And Family Therapy, A Professional Corporation | |
|
574 Manzanita Ave Ste 8 Chico CA 95926-1369 | |
| (530) 570-2453 | |
| Not Available |
| Full Name | Wild Goose Marriage And Family Therapy, A Professional Corporation |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 574 Manzanita Ave Ste 8, Chico, California |
| Authorized Official Name and Position | Marti Elizabeth Faye Tourville (PRESIDENT) |
| Authorized Official Contact | 5305880035 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wild Goose Marriage And Family Therapy, A Professional Corporation 550 Vallombrosa Ave, P.o. Box 2323 Chico CA 95926 Ph: (530) 570-2453 | Wild Goose Marriage And Family Therapy, A Professional Corporation 574 Manzanita Ave Ste 8 Chico CA 95926-1369 Ph: (530) 570-2453 |
| NPI Number | 1023962461 |
|---|---|
| Provider Enumeration Date | 02/23/2026 |
| Last Update Date | 02/23/2026 |
| Certification Date | 02/23/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023962461 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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